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Use of Biologic Therapy in Racial Minorities With Rheumatoid Arthritis From 2 US Health Care Systems
- Source :
- Journal of clinical rheumatology : practical reports on rheumaticmusculoskeletal diseases. 23(1)
- Publication Year :
- 2016
-
Abstract
- In the United States, there is racial/ethnic disparity in the care of rheumatoid arthritis (RA), yet there are limited data regarding the impact of varied health care systems on treatment outcomes.The aim fo this study was to compare the frequencies of use of disease-modifying antirheumatic drugs and biologic agents in racial minorities with RA in a single-payer and variable-access health systems.Rheumatoid arthritis disease status was examined in the Ethnic Minority Rheumatoid Arthritis Consortium (EMRAC) and Veterans Affairs Rheumatoid Arthritis Registry (VARA); frequencies of prednisone and disease-modifying antirheumatic drugs and biologic agent use at enrollment were documented. Comparisons in frequencies of RA therapies between RA cohorts and white and nonwhite racial subsets were evaluated.The combined cohorts provided 2899 subjects for analysis (EMRAC = 943, VARA = 1956). Routine Assessment of Patient Index Data 3 and Disease Activity Score in 28 Joints scores were equivalent (cohort, racial subsets), as was biologic agent use (26% vs. 28%) between whites and nonwhites. Disease-modifying antirheumatic drug use was greater in EMRAC nonwhites compared with their white counterparts, but similar to all VARA patients (33% vs. 22% [P0.001], 36%, 39%, respectively). However, biologic agent use was significantly greater in EMRAC versus VARA patients (37% vs. 22%, P0.001). In VARA patients, there was no difference in biologic agent use among racial subsets (22% vs. 21%). In EMRAC patients, biologic agent use was greater in whites than in nonwhites (EMRAC white 45% vs. EMRAC nonwhite 33%, P0.001; odds ratio, 1.66) and compared with all VARA subjects (EMRAC white 45% vs. all VARA 22%, P0.001; odds ratio, 2.91). Younger age, advanced education, longstanding disease, and severe disease were associated with biologic agent use.When compared with more variable-access systems, a VA system of care that includes a single-payer insurance may afford equality in use of biologic agents among different racial subsets.
- Subjects :
- Adult
Male
medicine.medical_specialty
MEDLINE
Ethnic group
Arthritis
Arthritis, Rheumatoid
03 medical and health sciences
0302 clinical medicine
Rheumatology
Health care
Medicine
Humans
Minority Health
030212 general & internal medicine
Registries
Minority Groups
Aged
030203 arthritis & rheumatology
Biological Products
Health Equity
business.industry
Middle Aged
medicine.disease
Health equity
United States
Antirheumatic Agents
Biological Therapy
Rheumatoid arthritis
Family medicine
Needs assessment
Physical therapy
Female
business
Needs Assessment
Subjects
Details
- ISSN :
- 15367355
- Volume :
- 23
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of clinical rheumatology : practical reports on rheumaticmusculoskeletal diseases
- Accession number :
- edsair.doi.dedup.....d3c0542e90cf79b27095cb0aef346b9b